Tuesday July 03, 2018 from 09:45 to 11:15
Integrating Outreach for Different Aspects of Chronic Kidney Disease Care: A TTS Transplantation Leadership Development Series Project
Kenneth Woodside1, Matthew D. McGuire2, Alexander S. Yevzlin2, Jeffrey D. Punch1, Randall S. Sung1.
1Transplant Surgery, University of Michigan, Ann Arbor, MI, United States; 2Interventional Nephrology, University of Michigan, Ann Arbor, MI, United States
At transplant centers, nephrologists and transplant surgeons work together to provide kidney transplant care to patients with chronic kidney disease (CKD). Many transplant centers also provide dialysis access placement services to their own and external CKD patients. While such dialysis access management is often integrated and multidisciplinary, patients are typically drawn from a smaller area clustered around the transplant center, rather than the larger area serviced by the transplant center’s kidney transplant program. However, there is a national need for complex dialysis access placement services that isn’t always available in smaller communities. Given this shortage, an integrated CKD outreach program may, by providing potential referring nephrologists with additional options for patients having difficulty establishing dialysis access that are not amenable to local resources, increase the likelihood of later transplant referral.
Methods:. As part of the Leadership Development Series program of the Transplantation Society (TTS), a project expanding and integrating outreach from the Multidisciplinary Dialysis Access Clinic (MDAC), a joint effort of Transplant Surgery and Interventional Nephrology, into the existing Transplant Center Kidney Program (TCKP) efforts was instituted.
Results & Discussion: A medical assistant was hired to support the additional efforts of the MDAC. A stand-alone website was designed for the MDAC that emphasized the multidisciplinary services offered by the MDAC, as a component of the Transplant Center. Links to the faculty websites for the surgeons and interventional nephrologists are included. Linkage from the Transplant Center website, as well as from Interventional Nephrology, are in progress. A brochure with similar content is under production.
Additional information about the MDAC was added to the TCKP outreach slides set, which is presented to referring nephrologists and dialysis units. For outreach talks within an hour’s drive, one of the dialysis access coordinators will accompany the kidney transplant outreach coordinators. For the longer distances, follow-up calls will be arranged for those interested. Similarly, information about the TCKP is included in the MDAC outreach information.
Aspects of the MDAC morbidity and mortality conference, as well as its quality assurance program, were integrated into, and supported by, the Transplant Center as well, to emphasize the integrated nature of CKD care provided by the TCKP program. Changes in referral patterns following outreach effort will be analyzed once the program has been active for a year.
Conclusion: Dialysis access affords an opportunity to engender good will from potential referring nephrologists. While any increase in access volume will likely have a high proportion of complex resource intensive patients, the potential to increase kidney transplant evaluation referrals may be significant.